Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Anthony O Amiewalan MD, SC

Organization Legal Medicine · NPI 1053543215

Anthony O Amiewalan MD, SC is a Legal Medicine in Decatur, Illinois. Licensed in Illinois. Registered with an NPI since 2009.

Licensed in
IL
In the registry since
2009
Specialties on file
3

Practice location Address checks out

2965 N Main St Ste A
Decatur, IL 62526-4397
Phone: (217) 422-0560
Fax: (217) 422-0872
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Legal Medicine (primary) Taxonomy 173000000X · Licence 036112019 (IL)
Clinic/Center Taxonomy 261Q00000X
Health Service Clinic/Center Taxonomy 261QH0100X

Record details

NPI number1053543215
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Anthony Amiewalan — Doctor · (217) 422-0560
Other names Anthony O Amiewalan Md Sc; Anthony O Amiewalan Md Sc
NPI enumeratedAugust 20, 2009
Last updated in NPPESMarch 27, 2025
Certification dateMarch 24, 2025
Mailing address2665 North Main Street, Suite A, Decatur, IL 62526-3803

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